A recent study has associated brain inflammation with depression and anxiety in patients with relapsing remitting multiple sclerosis (RRMS).
The study, “Neuroinflammation drives anxiety and depression in relapsing-remitting multiple sclerosis”, was published in the journal, Neurology and explored the inflammatory process in the development of psychiatric symptoms and the prognostic value of psychiatric comorbidities in MS.
Four hundred and five RRMS patients underwent psychiatric evaluation by means of Beck Depression Inventory II (BDI-II) and State/Trait Anxiety Inventory (STAI-Y). The inflammatory activity level was assessed by MRI. In a subset of 111 treatment-naive patients, CSF levels of proinflammatory cytokines were determined. Correlation and regression analyses were performed to determine associations between variables.
The results showed that relapsing MS patients demonstrated greater values of STAI-Y state and BDI-II compared with remitting patients but comparable trait-anxiety scores.
There were no significant differences in psychometric parameters between relapsing and asymptomatic MRI-active patients, highlighting the effect of subclinical inflammation on mood disturbances. A significant reduction of STAI-state and BDI-II scores was recorded, along with the subsiding of neuroinflammation. Interleukin-2 CSF levels were found to correlate with STAI-state, while tumour necrosis factor-α and interleukin-1β correlated with BDI-II. Because emotional disorders were associated with subclinical inflammation, variations of the psychometric profile were able to detect subclinical reactivation earlier. In line with this, high STAI-state values considerably predicted the possibility of disease reactivation.
Researcher concluded that mood alterations are induced by intrathecal inflammation, even though not clinically apparent, and are able to predict inflammatory reactivations in RRMS. Inflammation is therefore a biological event and not less important than the traditional psychosocial factors involved in mood disorders.